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. everett <br />�e <br />CITY ENGINEERS <br />EVERETT.WASHINGTON <br />The Undersigned <br />Hcreby applies for permission to <br />At the fallowing <br />(Work to be done) <br />i <br />:;�1� ��to�JS <br />APPLICATION FOR RIGHT•OF-WAY USE PERMIT <br />�uE�u4i� <br />SPACE. -4-c,;. <br />_��;�-r� �r�� (=���IT�����"; ''r_�!�l li��. ,�i lt<=�� <br />ORIVEWAY SECTION <br />NO SCALE <br />� .___— __— . —_—_ _ —"'I <br />I" LIP _�l <br />�30.+... . ____ _. . .____.L3� <br />� � <br />COPY OF- THIS APPI.ICATION TO <br />6[ POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259�8811 <br />24 HOURS 6EFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />— a� <br />Remarks <br />J. _ �: �.� - <br />PERMIT N0. <br />� <br />�� , <br />The undersigneJ owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims tor damages that may arise because of installa� <br />tion and maintenance of the improvement hereto <br />applied tor and turther agrees to remove same upon <br />notice fror� the City and ro replace public property <br />damaged diereby. <br />,, <br />SignaWre of Applicant . - <br />� <br />Address <br />` � � :�_� 1 -7 <br />Telephone Number <br />, � , .. . _. ,. . <br />Datc <br />Dept. Approvals <br />Engi <br />Communications <br />Approved 6y <br />Date Approved <br />